Career
INTENSIFIED PULMONARY TUBERCULOSIS CASE FINDING AMONG HIV-INFECTED NEW ENTRANTS OF A PRISON IN MALAYSIA: IMPLICATIONS FOR A HOLISTIC APPROACH TO CONTROL TUBERCULOSIS IN PRISONS

Purpose: This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia.

Design/methodology/approach: The study was conducted in Kajang prison, starting in July 2013 in the men's prison and June 2015 in the women's prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses.

Findings: Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232-526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48-5.68]).

Originality/value: Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.

Keywords: Entry; HIV; Malaysia; Prison; Tuberculosis; Xpert.

This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia.

Download PDF

Author

Haider Al-Darraji 1, Philip Hill 1, Katrina Sharples 1, Frederick L Altice 1, Adeeba Kamarulzaman 2

  • 1The Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia and Centre for International Health, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
  • 2Department of Medicine, Division of Infectious Diseases, University of Malaya, Kuala Lumpur, Malaysia and The Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.

Copyright

© Emerald Publishing Limited.

References

    1. Al-Darraji, H.A.A., Altice, F.L. and Kamarulzaman, A. (2016), “Undiagnosed pulmonary tuberculosis among prisoners in Malaysia: an overlooked risk for tuberculosis in the community”, Tropical Medicine & International Health, Vol. 21 No. 8, pp. 1049-1058.
    1. Al-Darraji, H.A.A., Kamarulzaman, A. and Altice, F.L. (2014), “Latent tuberculosis infection in a Malaysian prison: implications for a comprehensive integrated control program in prisons”, BMC Public Health, Vol. 14 No. 1, p. 22.
    1. Al-Darraji, H.A.A., Razak, H.A., Ng, K.P., Altice, F.L. and Kamarulzaman, A. (2013), “The diagnostic performance of a single GeneXpert MTB/RIF assay in an intensified tuberculosis case finding survey among HIV-Infected prisoners in Malaysia”, PLoS ONE, Vol. 8 No. 9, p. e73717.
    1. Banu, S., Rahman, M.T., Uddin, M.K.M., Khatun, R., Khan, M.S.R., Rahman, M.M., Uddin, S.I., Ahmed, T. and Heffelfinger, J.D. (2015), “Effect of active case finding on prevalence and transmission of pulmonary tuberculosis in Dhaka central jail, Bangladesh”, Plos One, Vol. 10 No. 5, pp. 1-15.
    1. Bhatnagar, T., Ralte, M., Ralte, L., Chawnglungmuana, Sundaramoorthy, L. and Chhakchhuak, L. (2019), “Intensified tuberculosis and HIV surveillance in a prison in northeast India: implementation research”, Plos One, Vol. 14 No. 7, pp. 1-11.
    1. Bick, J., Culbert, G., Al-Darraji, H.A., Koh, C., Pillai, V., Kamarulzaman, A. and Altice, F. (2016), “Healthcare resources are inadequate to address the burden of illness among HIV-infected male prisoners in Malaysia”, International Journal of Prisoner Health, Vol. 12 No. 4, pp. 253-269.
    1. Choi, P., Kavasery, R., Desai, M.M., Kamarulzaman, A. and Altice, F.L. (2010), “Prevalence and correlates of community re-entry challenges faced by HIV-infected male prisoners in Malaysia”, International Journal of STD & AIDS, Vol. 21 No. 6, pp. 416-423.
    1. Corbett, E.L., Marston, B., Churchyard, G.J. and De Cock, K.M. (2006), “Tuberculosis in Sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment”, The Lancet, Vol. 367 No. 9514, pp. 926-937.
    1. Dolan, K., Wirtz, A.L., Moazen, B., Ndeffo-mbah, M., Galvani, A., Kinner, S.A., Courtney, R., McKee, M., Amon, J.J., Maher, L., Hellard, M., Beyrer, C. and Altice, F.L. (2016), “Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees”, The Lancet, Elsevier Ltd., Vol. 388 No. 10049, pp. 1089-1102.
    1. Ferro, E.G., Culbert, G.J., Wickersham, J.A., Marcus, R., Steffen, A.D., Pauls, H.A., Westergaard, R.P., Lee, C.K., Kamarulzaman, A. and Altice, F.L. (2017), “Physician decisions to defer antiretroviral therapy in key populations: implications for reducing human immunodeficiency virus incidence and mortality in Malaysia”, Open Forum Infectious Diseases, Vol. 4 No. 1, doi: 10.1093/ofid/ofw219.
    1. Henostroza, G., Topp, S.M., Hatwiinda, S., Maggard, K.R., Phiri, W., Harris, J.B., Krüüner, A., Kapata, N., Ayles, H., Chileshe, C. and Reid, S.E. (2013), “The high burden of tuberculosis (TB) and human immunodeficiency virus (HIV) in a large Zambian prison: a public health alert”, PLoS ONE, Vol. 8 No. 8, doi: 10.1371/journal.pone.0067338.
    1. Jittimanee, S.X., Ngamtrairai, N., White, M.C. and Jittimanee, S. (2007), “A prevalence survey for smear-positive tuberculosis in Thai prisons”, The International Journal of Tuberculosis and Lung Disease: The Official Journal of the International Union against Tuberculosis and Lung Disease, Vol. 11 No. 5, pp. 556-561.
    1. Kranzer, K., Houben, R.M., Glynn, J.R., Bekker, L.G., Wood, R. and Lawn, S.D. (2010), “Yield of HIV-associated tuberculosis during intensified case finding in resource-limited settings: a systematic review and meta-analysis”, The Lancet Infectious Diseases, Vol. 10 No. 2, pp. 93-102.
    1. Kwan, C. and Ernst, J.D. (2011), “HIV and tuberculosis: a deadly human syndemic”, Clinical Microbiology Reviews, Vol. 24 No. 2, pp. 351-376.
    1. Meyer, J.P., Cepeda, J., Springer, S.A., Wu, J., Trestman, R.L. and Altice, F.L. (2014), “HIV in people reincarcerated in Connecticut prisons and jails: an observational cohort study”, The Lancet HIV, Vol. 1 No. 2, pp. e77-e84.
    1. Ministry of Health Malaysia (2012), “Health facts 2012”, available at: https://www.moh.gov.my/moh/resources/auto%20download%20images/589d6c0e20...
    1. Paião, D.S.G., Lemos, E.F., Carbone, A.D.S.S., Sgarbi, R.V.E., Junior, A.L., da Silva, F.M., Brandão, L.M., dos Santos, L.S., Martins, V.S., Simionatto, S., Motta-Castro, A.R.C., Pompílio, M.A., Urrego, J., Ko, A.I., Andrews, J.R. and Croda, J. (2016), “Impact of mass-screening on tuberculosis incidence in a prospective cohort of Brazilian prisoners”, BMC Infectious Diseases, Vol. 16 No. 1, pp. 1-8.
    1. Reid, S.E., Topp, S.M., Turnbull, E.R., Hatwiinda, S., Harris, J.B., Maggard, K.R., Roberts, S.T., Krüüner, A., Morse, J.C., Kapata, N., Chisela, C. and Henostroza, G. (2012), “Tuberculosis and HIV control in Sub-Saharan African prisons: ‘thinking outside the prison cell’”, Journal of Infectious Diseases, Vol. 205 No. SUPPL. 2, pp. 265-273.
    1. Sahle, E.T., Blumenthal, J., Jain, S., Sun, S., Young, J., Manyazewal, T., Woldeamanuel, H., Teferra, L., Feleke, B., Vandenberg, O., Rey, Z., Briggs-Hagen, M., Haubrich, R., Amogne, W. and McCutchan, J.A. (2019), “Bacteriologically-confirmed pulmonary tuberculosis in an Ethiopian prison: prevalence from screening of entrant and resident prisoners”, PLoS ONE, Vol. 14 No. 12, pp. 1-16.
    1. Sanchez, A., Gerhardt, G., Natal, S., Capone, D., Espinola, A., Costa, W., Pires, J., Barreto, A., Biondi, E. and Larouzé, B. (2005), “Prevalence of pulmonary tuberculosis and comparative evaluation of screening strategies in a Brazilian prison”, International Journal of Tuberculosis and Lung Disease, Vol. 9 No. 6, pp. 633-639.
    1. Sanchez, A., Massari, V., Gerhardt, G., Espinola, A.B., Eatri, Siriwardana, M., Camacho, L.A., Ntoni, B. and Larouzé, B. (2013), “X ray screening at entry and systematic screening for the control of tuberculosis in a highly endemic prison”, BMC Public Health, Vol. 13 No. 1, p. 983.
    1. Stuckler, D., Basu, S., Mckee, M. and King, L. (2008), “Mass incarceration can explain population increases in TB and multidrug-resistant TB in European and Central Asian countries”, PNAS, Proceedings of the National Academy of Sciences, Vol. 105 No. 36, pp. 13280-13285.
    1. Sultana, Z.Z., Hoque, F.U., Beyene, J., Akhlak-Ul-Islam, M., Khan, Md H.R., Ahmed, S., Hawlader, D.H. and Hossain, A. (2021), “HIV infection and multidrug resistant tuberculosis: a systematic review and meta-analysis”, BMC Infectious Diseases, Vol. 21 No. 1, pp. 1-13.
    1. Tulsky, M.C., Dawson, C., Hoynes, T.M., Goldenson, J., Schecter, G., J.P.W., Tulsky, J.P., White, M.C., Dawson, C., Hoynes, T.M., Goldenson J., and Schecter, G. (1998), “Screening for tuberculosis in jail and clinic follow-up after release”, American Journal of Public Health, Vol. 88 No. 2, pp. 223-226.
    1. United Nations Office on Drugs and Crime (UNODC) (2019), “Fast track to end AIDS by 2030: for people in prisons”, available at: www.unodc.org/unodc/en/hiv-aids/new/index.html
    1. Walmsley, R. (2018), “World prison population list (twelfth edition)”, available at: www.prisonstudies.org
    1. World Health Organization (WHO) (2001), Tuberculosis Control in Prisons. A Manual for Programme Managers, WHO Press, Geneva.
    1. World Health Organization (WHO) (2011), Guidelines for Intensified Tuberculosis Case-Finding and Isoniazid Preventive Therapy for People Living with HIV in Resource-Constrained Settings, WHO Press, Geneva.
    1. World Health Organization (WHO) (2014), “Global TB Report 2014”, Geneva.
    1. World Health Organization (WHO) (2021), WHO Consolidated Guidelines on Tuberculosis Module 2: Screening, WHO Press, Geneva, available at: www.who.int/publications/i/item/9789240022676
    1. Yanjindulam, P., Oyuntsetseg, P., Sarantsetseg, B., Ganzaya, S., Amgalan, B., Narantuya, J., Nishikiori, N. and Lambregts-van Weezenbeek, C. (2012), “Reduction of tuberculosis burden among prisoners in Mongolia: review of case notification, 2001-2010”, The International Journal of Tuberculosis and Lung Disease, Vol. 16 No. 3, pp. 327-329.